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General NPI Number Information
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NPI Number | 1265165146
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Entity Type | Individual
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Provider Name | NITIKA GUPTA DMD
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Gender | Female
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Dates
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Enumeration Date | 07/07/2022
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Last Update Date | 03/16/2025
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Provider Practice Location Address
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Address Line | 150 E. 58TH STREET 8TH FLOOR ANNEX
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City | NEW YORK
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State | NY
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Zip | 10155-1015
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Country | US
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Telephone | 646-988-2586
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Fax | 646-652-7722
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Provider Business Mailing Address
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Address Line | 8110 BLUEBONNET DR
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City | LORTON
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State | VA
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Zip | 22079-5684
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Country | US
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Telephone | 571-286-7344
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 06356301
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License Number State | NY
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